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Bk virus: a clinical review
M D Reploeg1, G A Storch, D B Clifford
1Department of Neurology, Washington University School of Medicine, St. Louis, MO 63110, USA. reploegm@medicine.wustl.edu
Abstract:
We present a review of the clinically oriented literature about BK virus, a relative of JC virus, which is the etiologic agent of progressive multifocal leukoencephalopathy (PML). The kidney, lung, eye, liver, and brain have been proposed as sites of BK virus-associated disease, both primary and reactivated. BK virus has also been detected in tissue specimens from a variety of neoplasms. We believe that BK virus is most often permissively present in sites of disease in immunosuppressed patients, rather than being an etiologic agent that causes symptoms or pathologic findings. There is, however, strong evidence for BK virus-associated hemorrhagic cystitis and nephritis, especially in recipients of solid organ or bone marrow transplants. Now that BK virus can be identified by use of specific and sensitive techniques, careful evaluation of the clinical and pathologic presentations of patients with BK virus will allow us to form a clearer picture of viral-associated pathophysiology in many organ systems.
Insights
BK virus, a JC virus relative, is reviewed for its role in disease, particularly in immunosuppressed patients. While often present permissively, it
Area of Science:
- Virology
- Immunology
- Pathology
Background:
- BK virus is a polyomavirus related to JC virus, the cause of progressive multifocal leukoencephalopathy (PML).
- BK virus has been implicated in diseases affecting various organs, including the kidney, lung, eye, liver, and brain.
- The virus has also been detected in neoplastic tissues.
Purpose of the Study:
- To review the clinical literature concerning BK virus.
- To elucidate the role of BK virus in various disease states, especially in immunocompromised individuals.
- To clarify the pathophysiology of BK virus-associated conditions.
Main Methods:
- Literature review of clinically oriented studies on BK virus.
- Analysis of proposed sites of BK virus-associated disease.
- Evaluation of evidence linking BK virus to specific pathologies.
Main Results:
- BK virus is frequently found permissively in diseased tissues of immunosuppressed patients.
- Strong evidence links BK virus to hemorrhagic cystitis and nephritis, particularly in transplant recipients.
- New sensitive detection techniques aid in understanding BK virus pathophysiology.
Conclusions:
- BK virus is often a permissive bystander rather than a direct cause of disease, except in specific cases like hemorrhagic cystitis and nephritis.
- Further evaluation of clinical and pathological presentations is crucial for understanding BK virus-associated pathophysiology.
- Advancements in detection methods facilitate a clearer understanding of BK virus's role in human disease.